Skip to main content
Erschienen in: International Urogynecology Journal 10/2020

03.06.2020 | Original Article

Long-term follow-up of native tissue anterior vaginal wall repair: does the POP-Q stage really reflect patients’ satisfaction rate?

verfasst von: Rok Šumak, Tamara Serdinšek, Igor But

Erschienen in: International Urogynecology Journal | Ausgabe 10/2020

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Anterior colporrhaphy (AC) is one of the most commonly performed surgical procedures for pelvic organ prolapse treatment; however, there are only few data in the literature regarding its long-term outcomes. Our aim was to assess the long-term efficacy and satisfaction rate after AC.

Methods

Patients who underwent AC at our institution from 2011 to 2014 were invited to this follow-up study, which took place in January–February 2019. Medical history and gynaecological examination with POP-Q assessment were performed. Patients filled out validated questionnaires UIQ-7, CRAIQ-7, POPIQ-7, PFIQ-7, POPDI-6, CRADI-8, and UDI-6 and evaluated their satisfaction with the procedure. Objective success was defined as anterior wall prolapse stage 0 or 1 assessed by the POP-Q system. Subjective success was defined as the absence of bulging sensation or a sense of falling out that can be felt or seen in the vaginal area. Data were analysed using descriptive statistics and non-parametric tests.

Results

Seventy out of 137 (51.1%) patients attended the follow-up. Mean follow-up period up was 74.1 ± 12.6 months. Two patients were excluded from the analysis because they had another surgical procedure due to central compartment prolapse. Of the remaining patients, 50 had AC and 18 had AC and posterior colporrhaphy (PC). Objective success rate was 13.2% and subjective success rate was 68.7%. Almost all patients (98.5%) were satisfied with the procedure. In the group of patients with objective recurrence, 66.1% had no prolapse symptoms.

Conclusion

Despite having a low objective success rate, patients’ satisfaction with AC is very high.
Literatur
1.
Zurück zum Zitat Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369(9566):1027–38.CrossRef Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369(9566):1027–38.CrossRef
2.
Zurück zum Zitat Kenton K, Mueller ER. The global burden of female pelvic floor disorders. BJU Int. 2006;98(Suppl 1):1–5 discussion 6-7.CrossRef Kenton K, Mueller ER. The global burden of female pelvic floor disorders. BJU Int. 2006;98(Suppl 1):1–5 discussion 6-7.CrossRef
3.
Zurück zum Zitat Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D, et al. Pelvic organ support study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192(3):795–806.CrossRef Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D, et al. Pelvic organ support study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192(3):795–806.CrossRef
4.
Zurück zum Zitat Samuelsson EC, Victor FT, Tibblin G, Svärdsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol. 1999;180(2 Pt 1):299–305.CrossRef Samuelsson EC, Victor FT, Tibblin G, Svärdsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol. 1999;180(2 Pt 1):299–305.CrossRef
5.
Zurück zum Zitat Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006;194(5):1455–61.CrossRef Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006;194(5):1455–61.CrossRef
6.
Zurück zum Zitat Caruso S, Bandiera S, Cavallaro A, Cianci S, Vitale SG, Rugolo S. Quality of life and sexual changes after double transobturator tension-free approach to treat severe cystocele. Eur J Obstet Gynecol Reprod Biol. 2010;151(1):106–9.CrossRef Caruso S, Bandiera S, Cavallaro A, Cianci S, Vitale SG, Rugolo S. Quality of life and sexual changes after double transobturator tension-free approach to treat severe cystocele. Eur J Obstet Gynecol Reprod Biol. 2010;151(1):106–9.CrossRef
7.
Zurück zum Zitat Vitale SG, La Rosa VL, Rapisarda AMC, Laganà AS. The importance of a multidisciplinary approach for women with pelvic organ prolapse and cystocele. Oman Med J. 2017;32(3):263–4.CrossRef Vitale SG, La Rosa VL, Rapisarda AMC, Laganà AS. The importance of a multidisciplinary approach for women with pelvic organ prolapse and cystocele. Oman Med J. 2017;32(3):263–4.CrossRef
8.
Zurück zum Zitat Shah AD, Kohli N, Rajan SS, Hoyte L. The age distribution, rates, and types of surgery for pelvic organ prolapse in the USA. Int Urogynecology J. 2008;19(3):421–8.CrossRef Shah AD, Kohli N, Rajan SS, Hoyte L. The age distribution, rates, and types of surgery for pelvic organ prolapse in the USA. Int Urogynecology J. 2008;19(3):421–8.CrossRef
9.
Zurück zum Zitat Sims JM (1866) Clinical notes on uterine surgery. Robert Hardwicke. Sims JM (1866) Clinical notes on uterine surgery. Robert Hardwicke.
10.
Zurück zum Zitat Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med. 2011;364(19):1826–36.CrossRef Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med. 2011;364(19):1826–36.CrossRef
11.
Zurück zum Zitat Nieminen K, Hiltunen R, Takala T, Heiskanen E, Merikari M, Niemi K, et al. Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up. Am J Obstet Gynecol. 2010;203(3):235.e1–8.CrossRef Nieminen K, Hiltunen R, Takala T, Heiskanen E, Merikari M, Niemi K, et al. Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up. Am J Obstet Gynecol. 2010;203(3):235.e1–8.CrossRef
12.
Zurück zum Zitat Maher C, Baessler K, Glazener CMA, Adams EJ, Hagen S. Surgical management of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn. 2008;27(1):3–12.CrossRef Maher C, Baessler K, Glazener CMA, Adams EJ, Hagen S. Surgical management of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn. 2008;27(1):3–12.CrossRef
14.
Zurück zum Zitat Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J. Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev. 2016;11:CD004014.PubMed Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J. Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev. 2016;11:CD004014.PubMed
15.
Zurück zum Zitat Vollebregt A, Fischer K, Gietelink D, van der Vaart CH. Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar-guided transobturator anterior mesh. BJOG Int J Obstet Gynaecol. 2011;118(12):1518–27.CrossRef Vollebregt A, Fischer K, Gietelink D, van der Vaart CH. Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar-guided transobturator anterior mesh. BJOG Int J Obstet Gynaecol. 2011;118(12):1518–27.CrossRef
16.
Zurück zum Zitat Weber AM, Walters MD, Piedmonte MR, Ballard LA. Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol. 2001;185(6):1299–306.CrossRef Weber AM, Walters MD, Piedmonte MR, Ballard LA. Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol. 2001;185(6):1299–306.CrossRef
17.
Zurück zum Zitat Minassian VA, Parekh M, Poplawsky D, Gorman J, Litzy L. Randomized controlled trial comparing two procedures for anterior vaginal wall prolapse. Neurourol Urodyn. 2014;33(1):72–7.CrossRef Minassian VA, Parekh M, Poplawsky D, Gorman J, Litzy L. Randomized controlled trial comparing two procedures for anterior vaginal wall prolapse. Neurourol Urodyn. 2014;33(1):72–7.CrossRef
18.
Zurück zum Zitat Rudnicki M, Laurikainen E, Pogosean R, Kinne I, Jakobsson U, Teleman P. A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. BJOG Int J Obstet Gynaecol. 2016;123(1):136–42.CrossRef Rudnicki M, Laurikainen E, Pogosean R, Kinne I, Jakobsson U, Teleman P. A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. BJOG Int J Obstet Gynaecol. 2016;123(1):136–42.CrossRef
19.
Zurück zum Zitat Milani AL, Damoiseaux A, IntHout J, Kluivers KB, Withagen MIJ. Long-term outcome of vaginal mesh or native tissue in recurrent prolapse: a randomized controlled trial. Int Urogynecology J. 2018;29(6):847–58.CrossRef Milani AL, Damoiseaux A, IntHout J, Kluivers KB, Withagen MIJ. Long-term outcome of vaginal mesh or native tissue in recurrent prolapse: a randomized controlled trial. Int Urogynecology J. 2018;29(6):847–58.CrossRef
20.
Zurück zum Zitat Lee U, Wolff EM, Kobashi KC. Native tissue repairs in anterior vaginal prolapse surgery: examining definitions of surgical success in the mesh era. Curr Opin Urol. 2012;22(4):265–70.CrossRef Lee U, Wolff EM, Kobashi KC. Native tissue repairs in anterior vaginal prolapse surgery: examining definitions of surgical success in the mesh era. Curr Opin Urol. 2012;22(4):265–70.CrossRef
21.
Zurück zum Zitat Maher C. Anterior vaginal compartment surgery. Int Urogynecology J. 2013;24(11):1791–802.CrossRef Maher C. Anterior vaginal compartment surgery. Int Urogynecology J. 2013;24(11):1791–802.CrossRef
22.
Zurück zum Zitat Chmielewski L, Walters MD, Weber AM, Barber MD. Reanalysis of a randomized trial of 3 techniques of anterior colporrhaphy using clinically relevant definitions of success. Am J Obstet Gynecol. 2011;205(1):69.e1–8.CrossRef Chmielewski L, Walters MD, Weber AM, Barber MD. Reanalysis of a randomized trial of 3 techniques of anterior colporrhaphy using clinically relevant definitions of success. Am J Obstet Gynecol. 2011;205(1):69.e1–8.CrossRef
23.
Zurück zum Zitat Dietz HP, Chantarasorn V, Shek KL. Levator avulsion is a risk factor for cystocele recurrence. Ultrasound Obstet Gynecol. 2010;36(1):76–80.CrossRef Dietz HP, Chantarasorn V, Shek KL. Levator avulsion is a risk factor for cystocele recurrence. Ultrasound Obstet Gynecol. 2010;36(1):76–80.CrossRef
24.
Zurück zum Zitat Wong V, Shek K, Rane A, Goh J, Krause H, Dietz HP. Is levator avulsion a predictor of cystocele recurrence following anterior vaginal mesh placement?: does levator avulsion predict cystocele recurrence after anterior mesh repair? Ultrasound Obstet Gynecol. 2013;42(2):230–4.CrossRef Wong V, Shek K, Rane A, Goh J, Krause H, Dietz HP. Is levator avulsion a predictor of cystocele recurrence following anterior vaginal mesh placement?: does levator avulsion predict cystocele recurrence after anterior mesh repair? Ultrasound Obstet Gynecol. 2013;42(2):230–4.CrossRef
25.
Zurück zum Zitat Fitzpatrick M, O’brien C, O’connell PR, O’herlihy C. Patterns of abnormal pudendal nerve function that are associated with postpartum fecal incontinence. Am J Obstet Gynecol. 2003;189(3):730–5.CrossRef Fitzpatrick M, O’brien C, O’connell PR, O’herlihy C. Patterns of abnormal pudendal nerve function that are associated with postpartum fecal incontinence. Am J Obstet Gynecol. 2003;189(3):730–5.CrossRef
26.
Zurück zum Zitat Snooks SJ, Swash M, Setchell M, Henry MM. Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet. 1984;324(8402):546–50.CrossRef Snooks SJ, Swash M, Setchell M, Henry MM. Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet. 1984;324(8402):546–50.CrossRef
27.
Zurück zum Zitat Lin Y-H, Liu G, Li M, Xiao N, Daneshgari F. Recovery of continence function following simulated birth trauma involves repair of muscle and nerves in the urethra in the female mouse. Eur Urol. 2010;57(3):506–12.CrossRef Lin Y-H, Liu G, Li M, Xiao N, Daneshgari F. Recovery of continence function following simulated birth trauma involves repair of muscle and nerves in the urethra in the female mouse. Eur Urol. 2010;57(3):506–12.CrossRef
28.
Zurück zum Zitat Summers A, Winkel LA, Hussain HK, DeLancey JOL. The relationship between anterior and apical compartment support. Am J Obstet Gynecol. 2006;194(5):1438–43.CrossRef Summers A, Winkel LA, Hussain HK, DeLancey JOL. The relationship between anterior and apical compartment support. Am J Obstet Gynecol. 2006;194(5):1438–43.CrossRef
29.
Zurück zum Zitat Rooney K, Kenton K, Mueller ER, FitzGerald MP, Brubaker L. Advanced anterior vaginal wall prolapse is highly correlated with apical prolapse. Am J Obstet Gynecol. 2006;195(6):1837–40.CrossRef Rooney K, Kenton K, Mueller ER, FitzGerald MP, Brubaker L. Advanced anterior vaginal wall prolapse is highly correlated with apical prolapse. Am J Obstet Gynecol. 2006;195(6):1837–40.CrossRef
Metadaten
Titel
Long-term follow-up of native tissue anterior vaginal wall repair: does the POP-Q stage really reflect patients’ satisfaction rate?
verfasst von
Rok Šumak
Tamara Serdinšek
Igor But
Publikationsdatum
03.06.2020
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 10/2020
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-020-04353-x

Weitere Artikel der Ausgabe 10/2020

International Urogynecology Journal 10/2020 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.